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PUT-74-03
C-r-o-s-s-l-i-n-k International, Inc.
SUPPLIER EVALUATION FORM
EVALUATION TYPE: NEW SUPPLIER EVALUATION
COMPANY NAME:
SUPPLIER CODE:
CAGE CODE:
DUNS NUMBER:
ADDRESS:
CITY:
STATE/PROV:
ZIP/POSTAL CODE:
COUNTRY:
PHONE:
COMPANY TYPE:
MANUFACTURER
(PMA)
SERVICES
OTHER
PRODUCTS/SERVICES OFFERED:
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FAX:
DISTRIBUTOR
FAA Repair Station
Parts Mfr Appv’l
Do you manufacture products or services for other C-I Divisions, if so please list:
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COMPANY’S WEBSITE:
SUPPLIER CERTIFIES THAT IT IS (CHECK ALL THAT APPLY):
A Small Business Concern
A SBA Certified Small Disadvantaged Business
A Veteran-Owned Small Business
Historically Black Colleges & Universities / Minority Institutions
OTHER:
A Women-Owned Small Business
A Hub-Zone Small Business
Service-Disabled Veteran Owned
Native American
Large
NOTICE OF PENALTY - Under 15 U.S.C. 645(d), any person who misrepresents a firm’s status as a small, small disadvantaged, or women-owned small business concern in order to obtain a
contract to be awarded under the preference programs established pursuant to section 8(a), 8(d), 9, or 15 of the Small Business Act or any other provision of Federal law that specifically
references section 8(d) for a definition of program eligibility, shall (i) be punished by imposition of fine, imprisonment, or both; (ii) be subject to administrative remedies, including suspension and
debarment; and (iii) be ineligible for participation in programs conducted under the authority of the Act (FAR 52.219-1(d)(2)).
PERSON COMPLETING EVALUATION
Name:
Date:
Title:
Phone
Number:
Fax Number:
Email Address:
QUALITY ASSURANCE REPRESENTATIVE
Name:
Title:
Phone
Number:
Fax Number:
Email Address:
C-I REVIEWER RECOMMENDATION (Completed by C-I Representative only)
EVALUATING C-I DIVISION:
APPROVED
DISAPPROVED
CONDITIONAL:
(limited to following)
RESTRICTED
(Scope of restriction)
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
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PUT-74-03
C-I EVALUATOR’S NAME:
Date:
COMMENTS:
GENERAL INFORMATION
1. AREA IN SQUARE FEET
TOTAL:
MANUFACTURING:
WAREHOUSE (DISTRIBUTION ONLY):
CLEAN ROOM:
CLEAN ROOM CLASS (if applicable):
2. NUMBER OF PERSONNEL:
MANUFACTURING:
QUALITY ASSURANCE:
ENGINEERING:
WAREHOUSE (DISTRIBUTION ONLY):
3. WHAT PERCENT OF PRESENT WORK IS:
GOVERNMENT
%
COMMERCIAL
%
OTHER
%
4. DESCRIBE ANY SPECIAL PROCESSES THAT YOU PERFORM INCLUDING MILITARY SPECIFICATION, IF
APPLICABLE, (E.G. PLATING, PAINTING, SOLDERING, WELDING, WIRE WRAP, ETC). ATTACH ADDITIONAL
SHEET(S) IF NECESSARY.
LIST:
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5. IS THE COMPANY HEADQUARTERED IN THE UNITED STATES OF AMERICA? Y
N
IF NO, THEN WHAT COUNTRY?
6. DOES YOUR ESD PROGRAM COMPLY WITH MIL-STD-1686, MIL HANDBOOK 263 OR ANSI/ESD S20.20?
Y
N
N/A
7. LIST ANY INTERNATIONATIONALLY ACCEPTED WORKMANSHIP STANDARDS YOUR COMPANY COMPLIES WITH:

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8. ARE YOU C.A. S. E. REGISTERED? Y
N
9. WILL YOUR COMPANY NOTIFY C-I COMMUNICATIONS OF ALL SIGNIFICANT CHANGES TO
THE FACILITY’S QUALITY SYSTEM (including the revocation of any certifications)? Y
N
CERTIFICATIONS AND ACCREDITATIONS
(AS9100: ISO 9001;ISO/IEC 17025, FAA-AC-0056A, ISO/TS 16949, ANZI/NCSL Z540, FAA/PMA, CAA, EASA,
A2LA, CMMI, NADCAP etc.)
Certification
Cert
Type
Certifying Organization
Expiration
Registration Number
*If ISO or AS9100 certified, please furnish copies of ISO/AS certificate with Scope of Registration and attached pages.
*If you hold an FAA/CAA/EASA Repair Station certificate, please furnish the FAA/CAA/EASA certificate, Operations
Specifications, and FAA/CAA/EASA Anti-Drug and Alcohol Misuse Prevention Program documentation.
*Furnish any other copies of certifications/accreditations/letters of approval held by your company
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
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PUT-74-03
NOTE: IF THE PROSPECT OR CURRENT APPROVED SUPPLIER HAS A QUALIFIED QMS, OR THIS IS FOR A CURRENT
APPROVED SUPPLIER REEVALUATION, THIS ENTIRE SECTION MAY NOT BE REQUIRED. SEE PROCEDURE PUP-74-04
FOR FURTHER REEVALUATION INSTRUCTIONS.
QUALITY MANAGEMENT SYSTEM (QMS)
General
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Do you have a quality management system composed of
documented procedures?
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Are outsourced processes controlled by the QMS?
Y
N
N/A
COMMENT
Quality Manual (QM)
Do you have a Quality Manual
Does the QM contain or reference the procedures in the QMS and
describe their interaction?
Y
N
N/A
COMMENT
Control of Documents
Do you have a document control system?
Are documents approved for adequacy prior to use and reviewed
and updated when necessary?
Are current revisions of documents available for those who need to
use them?
Are obsolete revisions removed to prevent unintended use?
Y
N
N/A
COMMENT
Control of Records
Do you have a process to control Quality records?
Have you defined Quality records within your QMS?
Are records of inspections and tests maintained?
Are all records used to document the QMS legible, readily
identifiable and retrievable?
Are the defined controls used to identify, store, protect, retrieve,
and disposition records adequate?
Are quality records retained for a specified period of time?
Y
N
N/A
COMMENT
Y
N
N/A
COMMENT
Quality Policy
Do you have a Quality Policy?
Y
N
N/A
COMMENT
Quality Planning
Do you perform quality planning
Are measurable quality objectives established and communicated
to all relevant functions
Y
N
N/A
COMMENT
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Management Responsibility, Authority & Communication
Do individuals responsible for quality have the necessary authority
to make decisions that impact the quality of the product?
Y
N
N/A
COMMENT
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Management Review
Do you conduct periodic management reviews of the QMS?
Does the review include input from internal audits, customer
feedback, process performance and product conformity data?
Does the review output result in decisions to improve the QMS and
apply resources to improve the product?
Do you maintain records of management review?
Y
N
N/A
COMMENT
Y
N
N/A
COMMENT
Y
N
N/A
COMMENT
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MANAGEMENT RESPONSIBILITY
Management Commitment
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Does top management have a process for communicating the
importance of meeting customer, statutory and regulatory
requirements to the organization
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RESOURCE MANAGEMENT
Provision of Resources

Do you have adequate resources to meet and maintain quality
requirements?
Human Resources/Training
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
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Do you have a documented training program for employees
performing work affecting product quality?
Does this program include the definition of the required
competencies?
Do you ensure employees have the education, training, skills or
experience necessary to meet these requirements?
Do you evaluate the effectiveness of this training?
Do you maintain records of training?
PRODUCT REALIZATION
Planning of Product Realization

Do you develop plans and/or processes for manufacturing product
to meets requirements?
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Are inspection and test activities based on product acceptance
criteria?
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PUT-74-03
Y
N
N/A
COMMENT
Customer-related processes
When customer requirements change, is there a process that
ensures relevant personnel are notified and relevant documents
are amended?
Is there a process for communicating with customer on product
information, enquiries, contracts or order handling, including
amendments and customer feedback?
Are product related requirements reviewed prior to commitment to
supply product to customer?
Are records of the review and actions rising from the review
documented and maintained?
Y
N
N/A
COMMENT
Design & Development
Do you maintain a process for implementation of design changes?
Is your organization responsible for design of product purchased
by C-I Communications? (If No, skip to next section)
Are plans prepared for each design or development activity that
includes review, verification & validation milestones?
Are design reviews conducted at planned intervals?
Are the responsibilities, authorities and organizational interfaces
defined for implementation of these plans?
Do design inputs include product functionality, performance,
statutory and regulatory requirements?
Is the design output documented and expressed in terms that can
be validated against the design input requirements?
Does the output provide adequate information for purchasing,
production and service and include product acceptance criteria?
Do you maintain records associated with the design process?
Y
N
N/A
COMMENT
Purchasing
Are procurement sources evaluated and monitored?
Do you specify applicable quality requirements to the supplier?
Do you maintain a documented system for the verification of
purchased product?
Do you maintain an “Approved Supplier Listing”?
Is criteria for selection, evaluation and re-evaluation (including
requesting corrective action when appropriate) of suppliers
established and are evaluations documented?
Do you maintain records of supplier evaluations?
Y
N
N/A
COMMENT
Control of Production & Service
Do you perform in-process inspection?
Are process capabilities established and maintained?
Are procedures for equipment and facilities maintenance
established?
Are production and/or service carried out under controlled
conditions?
Do conditions include the availability of acceptance criteria, work
instructions and monitoring equipment?
Are records available to substantiate acceptability of product?
Y
N
N/A
COMMENT
Y
N
N/A
COMMENT
Validation of Processes
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
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Are processes validated where the product cannot be verified by
subsequent monitoring & measuring?
Do validations include defined criteria for review and approval of
processes?
ID & Traceability
If required, do you have the ability to provide traceability?
Are incoming materials identified and segregated until
acceptance?
Are materials in stores identified and controlled?
Are in-process materials identified and controlled?
Is the status of inspection identified throughout product realization?
Do you maintain records demonstrating product identification and
traceability when required?
Y
N
N/A
COMMENT
Customer Property
Do you utilize any customer provided product or equipment in your
process?
Is customer property identified and stored to prevent loss or
damage?
Do you have a mechanism to alert the customer if their property is
damaged or lost?
Do you maintain records of damage or loss?
Y
N
N/A
COMMENT
Preservation of Product
Do procedures or processes exist for the storage, protection,
handling, and preservation of product?
Is the conformity of the product preserved internally and during
delivery to the intended destination?
Do you have a process to manage shelf life or age control
materials?
Y
N
N/A
COMMENT
Control of Measuring Devices
Do you utilize any inspection, measuring or test equipment in your
processes for the acceptance of product or services supplied to CI?
Are measuring and test equipment uniquely identified?
Is the calibration status of measuring and test readily identifiable?
Is measuring and test equipment used for acceptance calibrated
against nationally accepted standards?
Does the program account for and require disposition of product
previously accepted, when equipment is found out of calibration or
out of tolerance?
Do you maintain records of calibrations?
Y
N
N/A
COMMENT
Y
N
N/A
COMMENT
Internal Audit
Do you maintain an internal audit program?
Are audits performed in accordance with an established schedule?
Are audits performed objectively and impartially with auditors not
auditing their own work?
Is action taken to eliminate the causes of nonconformances
discovered by the audits?
Do you maintain records of internal audits?
Y
N
N/A
COMMENT
Monitoring & Measurement of Processes
Are processes monitored and measured to demonstrate
achievement of planned results?
Is action taken if processes are not producing planned results or to
achieve continual improvement?
Y
N
N/A
COMMENT
MEASUREMENT, ANALYSIS & IMPROVEMENT
Customer Satisfaction
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Do you have a method to measure customer satisfaction?
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PUT-74-03
Monitoring & Measurement of Products
Y
N
N/A
COMMENT
Do you monitor or measure the characteristics of your products
Do you have documented procedures that contain acceptance
criteria?
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
Page 6 of 7
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PUT-74-03
Is the final release of product approved by a relevant authority?
Do you maintain records of the acceptability of products?
Control of Nonconforming Product
Do you control nonconforming material to prevent its unintended
use or delivery?
Do you have a documented procedure for the control of
nonconforming product?
Are nonconforming items identified, segregated and controlled?
When nonconforming product is corrected, is it subject to reverification to demonstrate conformance to requirements?
Do you seek customer approval when necessary regarding the
disposition of nonconforming product?
Do you maintain records of nonconforming product including its
disposition?
Y
N
N/A
COMMENT
Analysis of Data
Do you use process/product quality data to facilitate necessary
actions and continual improvement?
Y
N
N/A
COMMENT
Continual Improvement
Do you have a formal process for continual improvement?
Y
N
N/A
COMMENT
Corrective Action
Do you have a documented procedure for corrective action?
Are nonconformances evaluated to determine the root cause?
Are corrective actions sufficient not only to correct the problem but
also to prevent recurrence?
Are corrective actions reviewed to assess effectiveness?
Do you maintain records of corrective actions?
Y
N
N/A
COMMENT
Preventive Action
Do you have a documented procedure for preventive action?
Are potential nonconformances evaluated to determine the root
cause?
Are actions taken to eliminate potential nonconformances and
prevent occurrence?
Are preventive actions reviewed to assess effectiveness?
Do you maintain records of preventive actions?
Y
N
N/A
COMMENT
DISTRIBUTOR PROCESSES ONLY - N/A
(Manufacturers check N/A)
Y
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N
N/A
COMMENT
Are you a franchised Distributor?
Are machines used for processing, packaging and inspections
checked/calibrated periodically?
Are age controlled items and shelf life items current and identified?
Are procedures used to stop the issuing of out-of-date shelf life
items?
Are shipping documents reviewed for accuracy, destination and
necessary requirements?
Are there time limits, statute of limitations, or restrictions for the
returning of defective products? (if so, describe in “Comments”)
Would you be willing to stand behind your delivered Dock to Stock
products for an extended time frame due to no Incoming Inspection
at some C-I Communications Divisions?
Note: Product received Dock to Stock may be discovered to be incorrect or defective for up to 12 months after
receipt because next higher assemblies are not usually built until all sub-parts are received and stocked.
Additional Area for Comments:
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D
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PUT-74-03
Revision History
Rev
A
B
C
D
EC No.
Initial Release
EC-100708-01
EC-101014-01
EC-150219-01
Initials
SNP
SNP
SNP
SNP
The Information contained in this document is PROPRIETARY and CONFIDENTIAL to Crosslink International, Inc. Its use, in whole or in part,
without written permission by Crosslink International, Inc. is PROHIBITED
Revision D